October 4, 2023: TEN-4 Day

WHEREAS, Children under 4 years of age are at a higher risk of serious physical injury or death as a result of child abuse; and,

WHEREAS, annually, there are nearly 600,000 victims of child physical abuse and/or neglect documented in the United States. In 2022, there were 24,590 confirmed cases of child abuse and/or neglect in Michigan; and,

WHEREAS, annually, approximately 1,800 children die due to child abuse and neglect in the United States. In 2022, 61 children died as a result of child physical abuse and/or neglect – child physical abuse is a serious public health problem; and,

WHEREAS, recognizing the earliest signs of physical abuse may prevent tragic outcomes; and,

WHEREAS, bruising is the most common and visible sign of physical child abuse. Bruising is the most common injury to be overlooked or misdiagnosed as nonabusive before an abuse-related fatality or near-fatality in a young child; and,

WHEREAS, the bruising clinical decision rule known as TEN-4 FACESp can help screen children at risk for abuse by identifying bruising characteristics that have been demonstrated to determine abuse from accidental injuries; and,

WHEREAS, TEN-4-FACESp helps screen children under 4 years of age with bruising to identify when a bruise is more likely to be caused by abuse than accidental injury. TEN-4-FACESp stands for bruising to the Torso, Ears, Neck, Frenulum, Angle of the jaw, Cheeks, Eyelids, or Subconjuctivae. The “4” also represents infants 4 months and younger with any bruise, anywhere, and p represents the presence of patterned bruising: and,

WHEREAS, an easy-to-use clinical decision rule is especially critical for infants and young children, who are at the highest risk of serious, potentially fatal abuse; and,

WHEREAS, the majority of child physical abuse victims are younger than four years of age, a vulnerable population whose safety and well-being relies on adults to intervene and protect; and,

WHEREAS, the State of Michigan recognizes the need to improve education for mandated reporters of child abuse, including using the TEN-4-FACESp clinical decision rule, to be better prepared to recognize physical signs of child abuse; and,

WHEREAS, more information regarding the TEN-4-FACESp screening tool can be found at: https://research.luriechildrens.org/en/community-population-health-and-outcomes/smith-child-health-outcomes-research-and-evaluation-center/tricam/ten-4-facesp/;